亚低温结合早期机械通气治疗重型弥漫性轴索损伤

Severe diffuse axonal injury treated by hypothermia combined with artificial ventilation

目的观察早期运用亚低温及机械通气治疗重型弥漫性轴索损伤的疗效。方法将140例重型弥漫性轴索损伤患者伤后24h内分成常温组(34例)、亚低温组(42例)、亚低温结合机械通气组(64例)进行治疗。伤后3个月采用格拉斯哥(GOS)评分进行疗效分析。结果常温组死亡16例(47.5%),亚低温组死亡14例(33.3%),亚低温+机械通气组死亡19例(29.7%),3组间较好疗效依次为:亚低温+机械通气组、亚低温组、常温组,P均<0.05;呼吸、心率及血气分析各项指标疗效亦如此(P均<0.05)。结论采用亚低温结合机械通气治疗可明显改善重型弥漫性轴索损伤病情,提高生存质量,降低残死率。

Objective To observe the clinical effect of severe diffuse axoual injury （DAI） treated by combination of hypothennia and artificial ventilation.Methods 140 patients with DAI admitted within 24 hours were divided into 3 groups： room temperature group, hypothemfia group and hypothennia combined with artificial ventilation group. All the patients were evaluated by Glasgow Outcome Scale after 3 .months. Results The death cases in room temperature group were 16 （47.5%） ,which in hypothermia group were 14 （33.3%） and hypothermia combined with artificial ventilation group were 19 （29.7 % ）. There were significant differences in therapeutic effects among these groups （ P 〈 0.05）. Conclusion Hypothermia combined with artificial ventilation can improve clinical efficacy for DAI, increase the quality of life and decrease the mortality.